This invention relates to apparatus utilized in post-tracheotomy procedures. More particularly it relates to tracheotomy tubes and moist air plenum masks.
Tracheotomy is a common surgical procedure. An opening is made into the trachea and an indwelling device called a tracheotomy tube is inserted. This allows for bypass of an upper airway obstruction, removal of tracheobronchial secretions, permitting the use of mechanical ventilation, preventing aspiration of oral or gastric secretions into the trachea in the unconscious or paralyzed patient and replacing an endotracheal tube. The tracheotomy tube itself is normally integral with a base plate having a hole therethrough for receiving the tube. The base plate is made to be flush against the outside of a patient's neck.
Various means for holding the tracheotomy tube in place have been devised over the years, including the use of adhesive tape as well as a thin elastic strap. U.S. Pat. No. 4,331,114 issued to Wapner teaches a substantial improvement for securing a tracheotomy tube in position on a patient. The Wapner patent teaches the use of first and second straps made of soft sponge-like materials forming a soft band surrounding the patient's neck which is both comfortable to the patient and easy to adjust due to the placement of VELCRO on the outside surface of the first strap and on the inside surface of the second strap. The band is secured to the tracheotomy tube base plate by a pair of strips extending through a pair of open slots in the base plate.
When using a tracheotomy tube, the normal moistening facilities of the patient's nasal passages are bypassed, resulting in substantially dry air being breathed by the patient. This problem is exacerbated in hospitals and nursing facilities where there is air conditioning and the humidity is already low. Therefore, it is common practice to supply the tracheotomy patient with moist air to the outside opening of the tracheotomy tube.
The application of moist air is normally accomplished through a tracheotomy mask which is received over the tracheotomy tube holder. An example of such tracheotomy mask is shown in U.S. Pat. No. 3,236,236 issued to Hudson. The Hudson patent shows a tracheotomy mask connected to a source of moist air. The mask acts as a plenum and covers the tracheotomy tube holder. The mask is separately held in place on the front of the patient's neck by a thin elastic band which contacts the back of the neck.
Thus, in situations where moist air is added to the patient, it is common practice to use a tracheotomy tube holder such as shown in the Wapner patent and a separate tracheotomy mask as shown in the Hudson patent. This results in two separate straps around the patient's neck, one of which is thin and irritating to the patient.
The care of tracheotomy patients by nurses in hospitals and nursing facilities requires substantial time and effort. It is common for the tracheotomy tube to be adjusted at regular intervals such as every two to four hours, or as needed. This requires the removal of the moist air mask. To apply and to remove the tracheotomy mask, the nurse must lift the patient's head in order to apply or remove the elastic band around the patient's neck. This exposes the nurse to the patient's bodily fluids and is further disruptive to the patient. In addition, the elastic band often becomes entangled with the patient's hair. Furthermore, because the elastic band is thin, it can leave marks on the patient's neck and cause general discomfort to the patient and, in some cases, skin damage.